During a successful Phase 1 effort, Etiometry and Boston Children's Hospital developed a novel Risk Monitoring System (RMS) to assist with the postoperative care of a vulnerable and clinically challenging neonatal population: infants with surgery for congenital heart defects. The system comprehensively integrates multiple physiologic signals to extract and deliver in real time actionable information about a patient's physiologic state, and thus support effective and timely interventions. The Phase 2 effort will deploy and integrate the system into the clinical workflow at Boston Children's Hospital, Children's National Medical Center in Washington D.C., The Hospital for Sick Children (Toronto), and St. Louis Children's Hospital, and evaluate its impact on process of care and patient outcomes. In addition, Etiometry will collaborate with Children's Hospital of Philadelphia (CHOP) Center for Simulation, Advanced Education and Innovation to test the safety, efficacy, usability, and performance characteristics of the system's User Experience (UX) and will refine it to optimize its clinical utility. The ultimate objective of the proposed SBIR effort will be demonstrate that the RMS can significantly affect the quality and cost of care of neonates post-surgery for congenital heart defect.